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Home Asia How To Interpret Data: On COVID Vaccinations, Case Numbers And Death Counts

How To Interpret Data: On COVID Vaccinations, Case Numbers And Death Counts


APRIL 17, 2021

A health worker collects nasal sample of a man for COVID-19 test, amid a surge in coronavirus cases, at HB Kanwatia Hospital in Jaipur,Rajasthan, India, Thursday, April 15, 2021.(Photo by Vishal Bhatnagar/NurPhoto via Getty Images)

You must have heard the old adage: if you torture the data enough, it will confess to anything. Let me add an important note of caution to this. If you begin by confessing to everything, the data will torture you. With the COVID-19 pandemic, the public has been hit with a flurry of data; on daily case numbers, vaccinations, death counts and the like. They have also been exposed to a variety of data-related terms, such as flattening the curve, reproduction number, doubling time and so on. Now, as any interaction with a class of middle or high school students will quickly convince you, numbers are not everyone’s best friend. And, when numbers on COVID begin hitting you from all sides, it can be overwhelming. Coupled with the human tendency to fear the worst, it will make you numb.

In this forest, the data snipers will thrive. Because it is only too simple to pick up say state-level data from somewhere along with some metric and tell you how bad things are. Then, you can pick up another metric and maybe country-level data from somewhere else and reinforce the same feeling of hopelessness. Somebody is doing the best in vaccinations, someone else is keeping the case counts low, someone has high case counts but low death numbers. And hence, depending on your agenda, you can draw whatever conclusion you want: The BJP-ruled states are the worst, the Congress-ruled states are the worst, European countries are doing the best, anything.

But if you observe closely, no one entity is doing the best or the worst on all of these metrics. If you fix a state or country and follow up on its performance on all metrics over the course of time, the picture is generally very spotty. Let me give an example. Many would remember how New Zealand Prime Minister Jacinda Arden became a global icon last year for her supposedly efficient handling of the pandemic. Seeing the coverage, several Indians would have wondered: why can’t we be like that?

Well, let us follow up. How is New Zealand doing on vaccinations? As on date, only about 2 per cent of people in New Zealand have received at least one dose of vaccine. Compare this to around 7 per cent in India. When you compare the total size of our population and think about our challenges, New Zealand now seems so inept in comparison that it is almost laughable. But that is the point. India should never have been compared to New Zealand; not now, not ever. And yet, we let ourselves be hoodwinked last year. That was, thanks to folks with an agenda, who I call data snipers. They came, they fired and they ran.

But the data snipers have a way out. They say they just want the best for us, on everything. This is a fallacy and I will get to it later. First, let us talk about how India is really doing.

Yesterday, India reported roughly 2 lakh new cases and over 1000 deaths. While each of these is a human tragedy, unprecedented hard times such as World War 2 or COVID-19 force us to keep things in perspective. Right now, most of Europe as well as Canada are building up to their third wave. In the US, the picture is slightly better right now, although there are early signs of a fourth wave emerging.

How bad are these waves? As it turns out, really bad. So much so that the second and third waves make the first one look like a ripple. On Friday, France reported some 40,000 cases and close to 400 deaths. Considering that India’s population is over 20 times more, it puts our COVID numbers in a somewhat different light. By no means have I cherry picked France here. Next door Germany reported 30,000 new cases and about 250 deaths on Friday.

This is where the first of our gnawing insecurities about India comes in. Are our numbers as reliable as those from say France or Germany? Maybe not. Maybe we are under-counting and under-reporting. The trick is not to stop there, but to ask: by how much? Take the death count of 400 from France, multiply it by 20 and you have 8,000. By contrast, India reported around 1,000 dead. So, even if you believe that 80 per cent of COVID deaths in India are going unreported, it would not make up the difference.

Some of our underlying assumptions about the West may not even be true. For instance, Germany does not count COVID deaths in cases where the deceased were suffering from comorbidities. This then is outright fraud. In New York, for example, nearly 6,000 COVID deaths in nursing homes were hidden by state authorities to save face for the ruling party during elections.

There are of course other ways to make excuses against ourselves and feel miserable. India has a young population and COVID mostly impacts the elderly. The median age in India is under-30, while in Western Europe, it is above-40. Okay, but if we are taking that into account, surely we should also note how much more resources the rich nations of the West have; about 20 times more per capita. At the moment, do we really expect the health systems in Lucknow or Patna to keep up with Paris? If we do, then surely there is something good to feel about India, after all.

Let us take vaccinations, which is the hottest topic right now. India has given at least one dose of vaccine to around 7 per cent of its population. This is low. But as many states have argued, the vaccines must go where the disease is. A useful way to think about this is to take our states and compare them to individual countries of Western Europe. The state of Gujarat, for instance, has 6 crore people, the same as France. Maharashtra has 12 crore people. These are two of our worst affected states right now. As of now, Gujarat has given 1 crore vaccine doses and Maharashtra around 1.2 crore doses. Although second doses come with a time lag, this suggests that Gujarat has so far given vaccines to around one in six people, or around 16 per cent. For Maharashtra, the rough calculation comes to 10 per cent.

In both France and Germany, around 16 per cent of people have received at least one dose of vaccine. While there is much to be desired regarding vaccine distribution in India so far, the numbers from India’s western states are definitely in the same ballpark as Western Europe. Rajasthan, which has a population of around 7 crore, has administered 1 crore doses as well, or roughly 14 per cent. The country of Italy also has a population of around 7 crore and has reached a coverage of around 17 per cent. While 14 per cent is less than 17 per cent, it is again in the same range. Did we mention that the World Health Organization had designated France as having the best healthcare system in the world, followed by Italy?

This is not to put a feel-good band-aid on a gaping wound. I also understand that this is cold comfort for someone who is suffering from COVID, or has lost a loved one to the pandemic. The purpose here is to show what an all-round, fair comparison looks like. We fixed on France and Germany, two rich nations with advanced healthcare systems and considered all metrics: case numbers, death counts, vaccinations. We looked at absolute numbers and we looked at percentages.

Let me come back to the issue of what I called data snipers and how to deal with them. When you see someone making a comparison, don’t jump to conclusions with one or two facts in front of you. Ask them to fix an entity, such as a state or a country, demand to know its performance on all metrics and follow it through time. More often than not, a data sniper will carry a toolkit consisting of deaths per million in Norway, daily case numbers in New Zealand, vaccinations as a percentage of population in Israel and total vaccination numbers from the US. These facts, cherry picked from individual states or countries around the world, a different metric from each country, mean nothing. In fact, this is how myths are born. For instance, if the famous Kerala model was real, it should have been possible to duplicate it elsewhere. Or at least in Kerala itself, when the State was hit by a second wave and now when it is hit by a third wave.

The problem of data sniping happens everywhere. But Indians are more vulnerable, generally due to our deep insecurities about our country. When presented with favorable data, it is all too easy to suspect that it may be wrong or fudged. The trick is to ask: by how much could it be fudged? Could it be that 80 per cent or more deaths are going unreported? At this point, your rational self will realize probably not.

Finally, here is the fallacy of listening to those who say why not have the best of every country. It may feel like they are setting us a noble goal, but they are not. Because the goal is not achievable, they are simply setting us up to fail. The question to ask is what is their agenda. Why did the same people, who pushed vaccine hesitancy in January and said vaccines were a waste of money in February, now say that we are not vaccinating fast enough? Are they well-wishers or are they simply hecklers?

Let me give another example of how such people play with our insecurities about India. A few days ago, I came across a report that the Prime Minister of Norway had been fined by the police for not wearing a mask! Many people wondered if India could ever reach a point of such transparency and fairness in law enforcement. Good question and probably well-intentioned. But when I searched the story on the internet, I realised that most websites reporting it were Indian. Why did this story not go viral in say Canada, the United States, Britain or France? Is it really possible that ruling political classes in all these countries never have a sense of entitlement nor corruption? Obviously not. But people in most western countries are not so insecure that they would beat themselves up over every little thing that happens elsewhere. In other words, good for Norway, but we have great things to show them too.

How has India fared during COVID-19? The pandemic hit us hard, because it hit us where we were weakest of all, in healthcare. But we made it through the first wave. Like everywhere else in the world, there were surprises, a lot of driving blind and getting blindsided. When you fix any state or country and compare on all metrics, India’s numbers look fair enough. There isn’t a model out there yet for stopping the pandemic, at least not in any free country. If it did, the West would not be dealing with second or third waves. Our economy suffered heavily in one quarter, but it recovered smartly and ultimately our GDP contraction for the whole year was less than that suffered by countries with advanced healthcare systems. As of now, India is running the world’s biggest vaccination programme. We are giving more vaccine jabs a day than most European countries give in a week. And absolute numbers matter. If they did not, China’s economic might would not worry anybody. In fact, China’s per capita GDP is not even in the global Top 50. It is the total size that makes a big difference.

Right now, India is fighting hard, against an invisible, microscopic enemy. We cannot afford to let our insecurities keep messing with our heads as we go about this fight.

Abhishek Banerjee is a mathematician, columnist and author. Views expressed are personal.

Follow the government’s latest travel advice if you are planning a trip outside India or travelling back to India from affected areas. You can also read World Health Organization’s advice on basic protective measures against the virus. WHO has also busted some myths surrounding coronavirus. The Ministry of Health’s special helpline is available at +91-11-23978046 and ncov2019@gmail.com.

Courtesy/Source: News18